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Benefits of using a self-expandable metallic stent as a bridge to surgery for right- and left-sided obstructive colorectal cancers

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Abstract

Purpose

To assess the benefit of placing a self-expandable metallic stent (SEMS) as a bridge to surgery for obstructive colorectal cancer (OCRC) according to the tumor site.

Methods

The subjects of this retrospective multicenter cohort study were 201 patients with OCRC, but without initial bowel perforation, who were treated either with a self-expandable metallic stent (SEMS) as a bridge to surgery (n = 109) or with primary surgery (PS; n = 92) between 2014 and 2016. The cohort consisted of 68 patients with right-sided and 133 left-sided OCRC. We evaluated the short-term surgical outcomes for each side.

Results

The SEMS group of patients with left-sided OCRC had significantly higher rates of primary resection, primary resection with anastomosis, stoma-free surgery, and laparoscopic surgery than the PS group of patients with left-sided OCRC. In contrast, the SEMS group of patients with right-sided OCRC had only a significantly higher rate of laparoscopic surgery than the PS group of patients with right-sided OCRC, but they had a longer overall hospital stay. There were no significant differences between the two treatment groups in the rates of morbidity or mortality, for either right-sided or left-sided OCRC.

Conclusion

The benefit of a SEMS as a bridge to surgery may be less for right-sided than for left-sided obstructions in colon cancer patients.

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Acknowledgements

We thank the collaborators in the institutions belonging to the CSGO: M. Miyake (National Hospital Organization, Osaka National Hospital), N. Miyoshi (Osaka International Cancer Institute), H. Tamagawa (Otemae Hospital), H. Ohta (Ikeda Municipal Hospital), Y. Nushijima (Suita Municipal Hospital), K. Danno (Osaka General Medical Center), H. Takemoto (Kinki Central Hospital of the Mutual Aid Association of Public School Teachers), Y. Fumimoto (Tondabayashi Hospital), and I. Ohashi (Hannan Chuo Hospital).

Author information

Authors and Affiliations

  1. Department of Surgery, Toyonaka Municipal Hospital, Shibahara 4-14-1, Toyonaka, Osaka, 560-8565, Japan

    Shunji Morita

  2. Department of Surgery, Bell Land General Hospital, Higashiyama 500-3, Naka-ku, Sakai, Osaka, 599-8247, Japan

    Kansuke Yamamoto

  3. Department of Surgery, Tane General Hospital, Kujyominami 1-12-21, Nishi-ku, Osaka, Osaka, 550-0025, Japan

    Atsuhiro Ogawa

  4. Department of Surgery, Kansai Rosai Hospital, Inabaso 3-1-69, Amagasaki, Hyogo, 660-8511, Japan

    Atsushi Naito

  5. Department of Surgery, Nissay Hospital, Itachibori 6-3-8, Nishi-ku, Osaka, Osaka, 550-0012, Japan

    Hitoshi Mizuno

  6. Department of Surgery, Nishinomiya Municipal Central Hospital, Hayashida-cyo 8-24, Nishinomiya, Hyogo, 663-8014, Japan

    Shinichi Yoshioka

  7. Department of Surgery, Osaka Rosai Hospital, Nakasone-cyo 1179-3, Kita-ku, Sakai, Osaka, 591-8025, Japan

    Tae Matsumura

  8. Department of Gastroenterological Surgery, Higashiosaka City Medical Center, Nishiiwata 3-4-5, Higashiosaka, Osaka, 578-8588, Japan

    Katsuya Ohta

  9. Department of Surgery, Itami City Hospital, Koyaike 1-100, Itami, Hyogo, 664-8540, Japan

    Rei Suzuki

  10. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita, Osaka, 565-0871, Japan

    Chu Matsuda, Taishi Hata, Tsunekazu Mizushima, Yuichiro Doki & Masaki Mori

  11. Department of Gastrointestinal Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan

    Junichi Nishimura

Authors
  1. Shunji Morita
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  2. Kansuke Yamamoto
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  3. Atsuhiro Ogawa
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  4. Atsushi Naito
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  5. Hitoshi Mizuno
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  6. Shinichi Yoshioka
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  7. Tae Matsumura
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  8. Katsuya Ohta
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  9. Rei Suzuki
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  10. Chu Matsuda
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  11. Taishi Hata
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  12. Junichi Nishimura
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  13. Tsunekazu Mizushima
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  14. Yuichiro Doki
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  15. Masaki Mori
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Consortia

Clinical Study Group of Osaka University (CSGO), Colorectal Group

  • M. Miyake
  • , N. Miyoshi
  • , H. Tamagawa
  • , H. Ohta
  • , Y. Nushijima
  • , K. Danno
  • , H. Takemoto
  • , Y. Fumimoto
  •  & I. Ohashi

Corresponding author

Correspondence to Shunji Morita.

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Conflict of interest

Shunji Morita and his co-authors have no conflicts of interest to declare.

Additional information

The members of “Clinical Study Group of Osaka University (CSGO), Colorectal Group” are listed in acknowledgement section.

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Morita, S., Yamamoto, K., Ogawa, A. et al. Benefits of using a self-expandable metallic stent as a bridge to surgery for right- and left-sided obstructive colorectal cancers. Surg Today 49, 32–37 (2019). https://doi.org/10.1007/s00595-018-1701-4

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  • DOI: https://doi.org/10.1007/s00595-018-1701-4

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